By Sue Hansard, First LymphCare. Achilles Tendon Case Study.
ACHILLES TENDON PATIENT:
60 year old female. Generally fit and well. Does daily Nordic walking 20 minutes. Regular pool swimmer.
PROBLEM 1:
9 years ago sustained left knee medial meniscus tear. 7 years ago partial meniscectomy to alleviate severe knee pain, locking and functional problems.
In the past 12 months medial knee pain has increased. Pain on climbing/descending stairs or impact exercises. Sometimes too painful for full weight bearing. Pain when driving.
PROBLEM 2:
10 years ago sustained damage to right achilles tendon. Since then chronic tendonosis: swelling, stiffness, nodular presentation with thickening and acutely tender from heel to calf muscle. Periodic treatments by Physiotherapist: deep massage, acupuncture and manipulation. Exercises done daily.
8/9/20 first treatment with LymphaTouch
KNEE:
SX: PAIN including at rest. Unable to fully weight bear. Pain ascending and descending stairs. Clicking and grainy sensation when mobilising patella over relaxed joint.
10mins /250mmhg/ intermittent and static (5 mins each) working popliteal nodes, then draining towards Popliteals. Using second smallest cup (35mm), and medium cup to work (50mm) around patella and especially focussing on medial knee, where oedema palpable and tenderness.
NEXT DAY:
Pain free. Able to use stairs without pain. No pain when driving. Lasted all day.
ACHILLES:
Using second smallest cup (35mm). Intermittent pressure 250mhg. From heel to calf 5 mins. Around medial and lateral malleoli. This area always very tender to pressure. 5 mins. Achilles acutely tender to light inward pressure. And feels thickened and stiff.
NEXT DAY:
Not as stiff on waking. Easier when Nordic walking early morning, no increased pain during exercise.
"Improved symptoms lasted for several weeks."
When `flare up’ of achilles pain and stiffness recurred, treatment repeated as above. 10 minutes, then twisting technique and 200MMHG over and along achilles from heel base to lower calf. Also 5 mins to lateral and medial malleolar areas with same cup and pressures.
These areas are often tender and `puffy’ and give patient sensation of weak ankle joint. Symptoms resolved, achilles tendon significantly less tender (pain score reduced from 8 out of 10, 10 being most painful, down to 3 out of 10). Ankle movement is more free and ankle itself feels more stable.
FEEDBACK:
- Easy to self administer
- Instructions on device easy to follow
- Easy to increase or reduce as needed
- Pressures comfortable and easy to tolerate for the patient
- Visible reduction of medial and lateral malleolar swelling afterwards
- Noticeable free-er ROM and achilles significantly less tender
- No morning stiffness for several days
"Wish I had access to this regularly. So much more tolerable than the deep friction work and acupuncture that physios have had to use in the past on my achilles!"
FOLLOWING TREATMENT:
Lake District for 9 days, daily walks on fairly level ground in sturdy walking boots. Accommodation on 1 level.
1. Tendon started to tighten up and become painful over the past week (walking in Lake District). It became nodular again with pain and tightening up into the calf
Treated it as before, yesterday and today it is less tender to pressure, no pain at rest.
2. Knee has been relatively pain free and `more stable'
Return home (2 storey house). Pain immediately on using stairs and appears swollen medially by the next morning.
Treated as before: Swelling reduced, and able to manage the stairs without pain for most of the day.
To find out more about the LymphaTouch, contact Physiquipe on 0161 713 0409 or info@physiquipe.com.